MEDICARE: WILLIAM BOGGS P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	VB007574	MI

General Provider Information

NPI Number	:	1689623530
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAM BOGGS P.C.

Provider Business Mailing Address
First Line	:	1121 N SAGINAW ST
Second Line	:	SUITE 2
City	:	HOLLY
State	:	MI
Zip	:	48442-1380
Country	:	US
Telephone Number	:	248-328-9291
Fax Number	:	248-328-9044

Provider Business Practice Location Address
First Line	:	1121 N SAGINAW ST
Second Line	:	SUIT 2
City	:	HOLLY
State	:	MI
Zip	:	48442-1380
Country	:	US
Telephone Number	:	248-328-9291
Fax Number	:	248-328-9044

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. VLADIMIR WILLIAM BOGGS
Credential	:	D.C.
Telephone Number	:	248-328-9291

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	10/21/2008

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